POWER WHEELCHAIRS
Many PALS find
that a power wheelchair provides a means of independent mobility when they are
no longer able to walk long distances. Before selecting a power wheelchair it
is important to consider what type of chair will meet the PALS’ long-term power
mobility needs. The following is a
brief overview of some of the features to consider when choosing a power
wheelchair.
Mid-Wheel or Rear-Wheel Drive
One of the
recent innovations in power mobility has been the development of mid-wheel
drive wheelchairs. In the past, most power wheelchairs had rear-wheel drive
which meant the wheelchair needed considerable room to turn.
E&J Metro
Now mid-wheel
drive chairs are also available. These can “turn on a dime”, which allow
wheelchair users to get around tight corners and turn in small rooms.
Pride Jazzy 1120
Before
choosing a particular mid-wheel or rear wheel drive chair, it is always
advisable to try the chair out in your own home to ensure it will work there.
Controller
It is
important to choose a controller that will meet the PALS’ needs over time. Most
PALS are initially able to use a joystick to drive a power wheelchair, provided
the user can reach the joystick as well as operate the on/off switches.
Typically, a joystick that has the switches closer to the user will work better
for the PALS.
P & G
Remote Plus with toggles
Purchasing a
joystick with switch jacks instead of switches will give the PALS even more
flexibility in controlling the wheelchair.
As the PALS’ dexterity changes, the switches can be moved to whatever
switch site works best.
Dynamic joystick with switch access
A swing away
joystick bracket should be considered if the user will be needing to get the
wheelchair close to a table or desk.
Some PALS lack the hand and arm strength to
use a joystick, so choose an alternate array consists of several switches
embedded in the headrest. Touching
different parts of the array will steer the chair in different directions
Quantum Head
Array
Some clients
find it easier to drive with a proportional head control. This type of control uses one switch (often
placed by the cheek) that acts as the gearshift, with the headrest acting as
the accelerator. By turning his head
the PALS is able to switch the direction he is driving. Extending his head back
into the headrest will control how far he travels in that direction.
Some
wheelchairs can be operated with a single switch and a scanner. This means it
is possible to drive a wheelchair with a finger tap or even a toe tap.
Power Tilt, Recline, and
Elevating Leg rests
Many power
wheelchairs come with optional power tilt, recline, and elevating leg
rests. The recline feature allows the wheelchair back to be moved forward
and back in isolation from the seat. “Tilt” refers to moving the wheelchair
back and seat together as a single unit.
If the PALS is
planning to use the chair throughout the progression of the ALS it is very
important that the wheelchair have tilt. This will add considerably to the cost
of the chair, however it will be worth it.
As the PALS trunk muscles weaken, tilting the wheelchair slightly will
allow the PALS to sit comfortably. Recline and power elevating leg rests are
“nice to have” features, but are not as crucial as the tilt.
Invacare Tilt System
To reduce the
cost of tilt or recline, it is often possible to get “after-market” systems put
onto the chair. Typically this costs less than purchasing the tilt system from
the wheelchair manufacturer.
When ordering
tilt, recline or power elevating leg rests, one should ensure these systems can
be operated through the joystick or whatever control the PALS is going to use.
This will probably increase the cost of the chair, but will often save the PALS
much frustration down the road.
Points to discuss with your
Vendor and Therapist
Your
occupational or physical therapist, as well as your local medical equipment
vendor, can assist you when selecting which power wheelchair might be best for
you. Here are some of the questions you
should consider before making a final decision.
·
Where will I be using the wheelchair?
Will it be used indoors or outdoors? If the wheelchair is to be used outdoors,
will there be rough or uneven ground? (A PALS living on an acreage may want a
wheelchair with good “curb climbing” ability.)
·
What is the turning radius of the
wheelchair? Will this work in my home?
·
Does the wheelchair have a weight limit?
·
Does the chair accommodate a tilt
system?
·
Can I operate the joystick and turn the
wheelchair on and off?
·
Will the chair accommodate other types
of controls (e.g. head control or single switch)?
·
Can I mount a seating system on the
wheelchair?
If you are
considering purchasing a second hand chair, it is advisable to find out if you
will be able to modify the chair at a later date. (e.g. ask if the electronics
are current enough to allow for alternate controls.)
Funding Sources
Power
wheelchairs vary greatly in prices. A
basic rear-wheel drive, joystick- controlled wheelchair will cost about $4000
to $7000. A mid-wheel drive wheelchair with after-market tilt will probably be
around $12,000. Alternate controls
(e.g. head control) will increase the cost even more.
The Alberta Aids to Daily Living (AADL)
program has limited funds available for basic power wheelchairs. Many private insurance plans will also
provide partial or full funding for power mobility. Service clubs and community organizations are often willing to
raise money for power wheelchairs.
Researching
all of the available power wheelchair options can be a time-consuming process,
but many PALS would agree that using a power wheelchair makes a huge impact on
their quality of life.
For more
information, check the following websites:
http://www.everestjennings.com/products/index.htm#Power%20Chairs
http://www.sunrisemedical.com/index.jsp
This information has been prepared for the ALS Society by Anne Chapman Heinemeyer, OT. For more information please phone Lyn Skipper Equipment Program Co-ordinator toll free in Alberta at 1 (888) 309-1111 or by e-mail at lyn@alsab.ca